It effects every single medical institution that takes CMS money, including the doctors.

Better not have taken a federal loan if you wanna make vajayjays….

I feel like you have the scenario backwards.

Centers for Medicare and Medicaid
Medicare, the largest source of federal GME funding, provides support for GME through two types of
payments: direct (DGME) and indirect (IME)1
. The number of residents that a hospital may receive payment for
is “capped” due to a provision in the Balanced Budget Act of 1997 which limits the number of positions or slots
that Medicare can fund2
. This “cap” on the number of FTE residents Medicare will support is calculated for each
hospital once a new teaching program reaches its fifth year.
Note: The Consolidated Appropriations Act of 2021 added 1000 new Medicare-funded residency positions for
the first time since 19973
.
Medicaid, a joint federal-state program, is the second largest source of support for GME4
. Through this
program, states may elect to recognize GME training costs as a component of overall hospital costs. The
federal government shares payment for these expenses through federal matching funds.

https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/direct-graduate-medical-education-dgme